Suresh Chand conspired with others to submit false claims for physical therapy and occupational therapy in excess of $18 million. The fraud was discovered but not before Medicare had paid $8.5 million of the claims. Yesterday, U.S. District Judge Sean F. Cox sentenced Chand to 81 months followed by three years of supervised release and ordered restitution of $9,769,113. Chand’s physical and occupational companies, Continental Rehab Services, Inc. and Pacific Management Services Inc. — which operated out of the same address — maintained “fictitious therapy files, appearing to document physical and occupational therapy services provided to Medicare beneficiaries, when in fact no such services were provided. The fictitious services reflected in the files were billed to Medicare through sham Medicare providers controlled by Chand and two of his co-conspirators,” says DoJ. The clinics run by Chand and his co-conspirators were mere illusion — from recruitment to billing to collection — the entire business was apparently a sham and involved a large number of players, including rogue physicians and physical therapists who were bribed into the scam:

“[Chand] paid cash kickbacks and other inducements to Medicare beneficiaries, in exchange for the beneficiaries’ Medicare numbers and signatures on documents falsely indicating that they had visited CRS or PM for the purpose of receiving physical or occupational therapy. Chand acknowledged recruiting hundreds of Medicare beneficiaries for this purpose, and paying them for their signatures with cash and prescriptions for controlled substances, including Vicodin, Xanax and Soma. Chand and his co-conspirators obtained the prescriptions for these drugs from co-conspirator physician Jose Castro-Ramirez, who prescribed controlled substances for beneficiaries he had never seen, for the purpose of recruiting those beneficiaries into the scheme. Chand also prepared fictitious therapy prescriptions and other documents, which when signed by Castro-Ramirez, falsely indicated he had ordered and monitored physical or occupational therapy services that were provided to the Medicare beneficiaries. To complete the fictitious files, Chand admitted that he and his co-conspirators obtained signatures from licensed physical or occupational therapists on “progress notes” and other documents in the therapy files, falsely indicating that the therapists had provided therapy services to the Medicare beneficiaries on those dates. Chand recruited a number of licensed physical and occupational therapists into the scheme, and paid these therapists a set fee per file that they helped falsify.”

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